Radha Mishra, a 'sahyogini' counseling Anita, a lactating mother, on breastfeeding their children, treating the children with diarrhea with ORS, sending the children for immunization and growth monitoring.
Effective communication requires research and analysis. Initial communication analysis is an important component of the larger situation analysis on the rights on children, conducted in support of national programming. The communication component of the situation analysis begins with formative research to gather baseline data, national and subnational information and audience insights related to the larger programme objectives.
In the communication analysis available demographic, health, socio-cultural, political, economic and media related data are gathered, reviewed and analysed through a range of quantitative and qualitative research methods. These include participatory techniques for gathering qualitative and quantitative evidence such as: Knowledge, Attitudes and Practice (KAP) surveys, Focus Group Discussions (FGDs), Multiple Indicator Cluster Surveys (MICs), Demographic and Health Surveys (DHS), Key Informant Interviews, Community Mapping, Social Network Analysis and others. Communication analysis also includes an analysis of participant groups; their health seeking and other behaviours that may hinder or enable desired behaviours, social norms and practices; and an analysis of communication channels.
For example, the success of Nepal's first radio programme for youth, Chatting with My Best Friend, would not have been possible without a thorough understanding of the young adult population that the programme serves. In order to generate this understanding, a Knowledge, Attitudes, Practices and Skills (KAPS) survey was conducted with a representative sample of 1,400 Nepali teenagers throughout the country, which pinpointed key findings and helped direct the scope of future broadcasts. A similar programme in Haiti trains youth to employ radio broadcast to speak out on issues that matter to them.
Venezuela's innovative 2011 campaign for exclusive breastfeeding was made possible by strong baseline research. The data showed only 27.8% of women exclusively breastfed their children (Survey of the National Institute of Nutrition 2006-2008). The research also specified a range of contributing factors such as changing parenting patterns, changing social roles of women, strong beauty stereotypes and little support for breastfeeding from healthcare centres. The specificity of the report led to the construction of a broad coalition of partners working together to create a campaign that ranged from community meetings to the inclusion of television personalities and a very popular supermarket breast-feeding 'product' that was placed next to infant formula.
Research is an on-going, continuous activity conducted at the inception of a C4D programme. It is integrated within all stages of the process of design and delivery to ensure that the initiative is evidence-based, focused, and strategic and able to make adjustments based on real time data. Uzbekistan implemented rigorous baseline research and analysis in order to bring health care to all children affected by the Aral Sea disaster. The KAP study identified and analyzed traditional beliefs, spheres of influence and deep-rooted practices that pose barriers to positive change. The study challenged some of the prevalent assumptions about power relations within the family and lead to new strategies to influence feeding practices of newborns and infants.
UNICEF C4D currently employs the Social Ecological Model (SEM) as a tool to provide a systematic approach to the multiple levels of influences affecting decision making. The SEM framework enables programmers to analyse barriers and constraints across and within all levels: individual, family, community, organizational/institutional and national. The resulting analysis allows programmes to design holistic, comprehensive interventions that encapsulate and interlink all levels of action necessary to address underlying immediate, multiple, structural, systemic and intersecting root causes influencing individual, communities and national policies.
Research and analysis occurs throughout the programme cycle
There are different types of participatory research to be done at each stage of the country programme cycle:
Type of Research
Examines current situation to
determine key behavioural,
and systemic drivers
What is the current situation?
Who are the most excluded and marginalised?
What rights are not being realised?
What are the barriers to change?
Create Objective and
baselines against which results
Will this overcome barriers to change?
Will this build the capacity of duty bearers and rights holders to protect human rights?
and early outcomes
Assess reach, quality, participant involvement, satisfaction and
empowerment of activities
Are planned activities being realized?
Is implementation adequate?
Is information provided?
Is participation supported?
Are we reaching the most excluded?
Measure behavioural, social
and cultural changes; determines
contribution of programme strategies to these results
Did it work or not, and why?
What outcomes are observed?
Will they be sustained?
What do the outcomes mean?
How could it be improved?
Research example from the field
Polio persists in Pakistan and successfully eradicating the disease requires more than delivering polio vaccine. High risk populations need to be identified and research must be conducted in order to better understand why vaccine is not being administered to all eligible children. In 2011, 40% polio cases in Pakistan were reported from Balochistan, a vast, sparsely populated province. Research showed that 90% of polio cases affected children from families where mothers had not received any formal education.
In response, UNICEF and the Government of Pakistan established a volunteer communication network, called COMNet, in high risk districts of the province. The 230 staff were all people from the community including district level, union council level and grass root level recruits. 99% of the staff deployed in Pashtun are Pashto speaking and all of the high risk areas were covered. The COMNet staff worked extensively on advocacy with prominent Pashtun political parties and community leaders. One such effort was engaging Pashtunkhaw Mili Awami Party (PKMAP), a democratic party representative of Pashtoon population in Balochistan and parts of Khyber Pakhtoon Khaw.
The advocacy efforts started with engagement of provincial and district leadership of the party highlighting the grimness of the situation amongst Pashtun speaking population. PKMAP leaders have shown their visible support for PEI at all levels. They have been involved in district/provincial inaugurations where they have exhibited their support by administering polio drops to children. Through community meetings where the party leaders have emphasised the importance of immunization amongst communities, they have organized polio walks with COMnet where they have marched to support a polio free Pashtun community and a polio free Balochistan.
The PKMAP party members have also contributed in addressing "refusal families" in the OPV (oral polio vaccine) resistant areas, during their rallies in Chaman bordering Afghanistan. They announced their support for the programme in front of 10,000 supporters and a similar rally was held in Pishin where more than 8,000 party supporters were present.
Constant efforts by COMNet and Deputy Commissioners to engage local political leadership has produced positive results. In June 2012, more than 5,000 refusal children were vaccinated through support of different political parties. Engaging local leaderships to support health programmes has been effective and with the continued support of national and local leaders, there is hope for polio eradication in Pakistan.